A qualitative exploration of Pakistan’s street children, as a consequence of the poverty-disease cycle

Abstract

BackgroundStreet children are a global phenomenon, with an estimated population of around 150 million across the world. These children include those who work on the streets but retain their family contacts, and also those who practically live on the streets and have no or limited family contacts. In Pakistan, many children are forced to work on the streets due to health-related events occurring at home which require children to play a financially productive role from an early stage. An explanatory framework adapted from the poverty-disease cycle has been used to elaborate these findings.MethodsThis study is a qualitative study, and involved 19 in-depth interviews and two key informant interviews, conducted in Rawalpindi, Pakistan, from February to May 2013. The data was audio taped and transcribed. Key themes were identified and built upon. The respondents were contacted through a gatekeeper ex-street child who was a member of the street children community.ResultsWe asked the children to describe their life stories. These stories led us to the finding that street children are always forced to attain altered social roles because health-related problems, poverty, and large family sizes leave them no choice but to enter the workforce and earn their way. We also gathered information regarding high-risk practices and increased risks of sexual and substance abuse, based on the street children’s increased exposure. These children face the issue of social exclusion because diseases and poverty push them into a life full of risks and hazards; a life which also confines their social role in the future.ConclusionThe street child community in Pakistan is on the rise. These children are excluded from mainstream society, and the absence of access to education and vocational skills reduces their future opportunities. Keeping in mind the implications of health-related events on these children, robust inter-sectoral interventions are required.

Health Status and Life Situation of Street Children in Zahedan, Southeast of Iran

“…Selling different goods and scavenging were the most common types of work activities among the subjects in this study that is consistent with results reported in Turkey (4) and Pakistan (13). Given the job status of children's fathers in this study, it seems that the street children usually choose the jobs like their fathers.…”

“…Although this rate was lower than that in the previous study in Tehran (7), the results showed the important role of Iranian families. However, family disruption is an important factor in the street youth phenomenon, and having a place for living might be more important than poverty (13). Therefore, providing a place at least for homeless children can decrease many problems regarding these children.…”

Parents’ Attitude Toward Child Abuse Conducted in the Health Centers of Tabriz

“…Also in the study of Nuhu and Nuhu there was significant relationship between parents' attitude toward child abuse with their income and poor parents had more positive attitude toward child abuse (13). Family poverty is an important factor in child abuse occurrence and numerous studies have shown that child abuse often happened in poor families (20)(21)(22)(23).…”

Developing a Coordinated Response to Counter the Public Health Menace of Street Children

“…Furthermore, most of them have to deal with multiple obstacles; including different forms of abuse which itself questions the integrity of their survival [5,6]. Acknowledging the global presence, enormous burden and involvement of dependant population, negative influence on the quality of life, and long-term impacts, the public health professionals have realized street children as a marginalized group of the society which needs immense attention and care [7].A broad range of socio-demographic, familial and health care delivery system associated factors such as wars and civil unrests [8], literacy status of parents [7,9], urbanization [3], absence of psychosocial support in the family [7], housing standards [4], financial stability in the family [3,9,10] large-sized families [10], familial conflicts [3],child abuse and neglect by the parents / relatives [3] either experiencing and/or witnessing domestic violence [1,9], negligible exposure to recreational activities [1,8] gender of the child [11], nonenrollment or drop-out from schools [1,3,] peer pressure, media role [7] and hostile behavior of police [12,13] have been recognized which augments the problem of street children. From the perspective of rehabilitation / child placement center, which is established to safeguard the interests of children, parameters like lack of care, attitude of the workers, strict rules within the centre itself, etc.…”